DM SHoes Survey

Name *

First Name

Last Name

What is the main reason you decided to wear diabetic shoes? *

Please check all that apply

Foot pain/painful callouses

I had a foot wound/ulcer

I have nerve damage and worry about foot complications

I know someoe who had an amputation

My doctor told me to wear them

When you don’t wear your Diabetic shoes, what is the main reason? *

Select all that apply

Shoes are too heavy

Shoes are too hard to put on and take off

I save them for only going outside the house

The shoes are ugly/embarrassing

I wear them all the time when weight bearing

Other